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Related Experiment Videos

New insights from ADVANCE.

John Chalmers1, Andre-Pascal Kengne, Rohina Joshi

  • 1The George Institute for International Health, University of Sydney and The Royal Prince Alfred Hospital, Sydney, NSW, Australia. jchalmers@george.org.au

Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension
|December 6, 2007
PubMed
Summary
This summary is machine-generated.

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The ADVANCE trial established the safety and efficacy of perindopril-indapamide for blood pressure reduction and gliclazide-MR for glucose control in type 2 diabetes patients. Further insights into combined treatment benefits are expected.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Trials

Background:

  • Type 2 diabetes mellitus (T2DM) is associated with significant macrovascular and microvascular complications.
  • Effective management of blood pressure and glycemic control are crucial in T2DM patients to mitigate these risks.

Purpose of the Study:

  • To evaluate the benefits of blood pressure lowering using perindopril-indapamide versus placebo.
  • To assess the efficacy of an intensive gliclazide-MR regimen targeting HbA1c ≤ 6.5% compared to standard therapy for glucose control.
  • To determine the combined and individual effects of these interventions on macrovascular and microvascular outcomes.

Main Methods:

  • ADVANCE was a large-scale, 2x2 factorial randomized controlled trial involving 11,140 participants with T2DM.

Related Experiment Videos

  • Participants underwent a 6-week run-in phase with open-label perindopril-indapamide.
  • Randomization allocated participants to either intensive or standard glucose-lowering therapy.

    • Main Results:

    • The run-in phase demonstrated the safety and tolerability of perindopril-indapamide, with only 3.6% withdrawal due to intolerance.
    • Over 4 years of follow-up, >80% of participants adhered to randomized therapy.
    • Blood pressure was reduced by an average of 8/3 mmHg during the run-in phase.

    Conclusions:

    • The safety and efficacy of perindopril-indapamide and gliclazide-MR have been confirmed.
    • The ADVANCE trial is expected to provide significant insights into the additive benefits of combined blood pressure and intensive glucose lowering in T2DM.
    • Further analysis will clarify the impact of these interventions on macrovascular and microvascular events.